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Q and A

Why is it so important for me to have a complete eye exam before my child starts school, instead of just a vision screening?

Experts say that 80 to 90 percent of what a child learns in school is done so visually. Therefore, having a comprehensive eye exam is critical for any child who will be starting school. A vision screening is very brief and does not thoroughly examine and diagnose a child. It is important to keep in mind that it is possible for a child to be able to see 20/20 however, this does not necessarily mean the child isn’t straining to do so. A school screening will check for 20/20 visual acuities and if that is met, the child is “normal” and is not in need of glasses. According to the American Optometric Association, “one in four children has an undetected vision problem. These vision problems are issues such as convergence insufficiency, amblyopia, eye teaming, poor depth perception – all of which are undetected by typical vision screenings”, this proves that visual screenings do not diagnose learning-related vision problems. A child might be able to “get by” without glasses, but parents need to be aware that glasses can benefit and help the child not just to “get by” in school, but also to exceed.

My child seems to be able to see fine when he’s with me, but tells me he has trouble seeing in school, what should I do?

It is common to see a child struggle with vision problems or only notice vision problems during school hours since it is where the child is using his/her vision most frequently. Symptoms may only be obvious when a child focuses while doing near work (e.g. reading, writing) or focusing at a distance (e.g. looking at the board, PowerPoint). Parents often overlook these problems at home and even limited eye exams such as school screenings can oversee these vision problems due to the lack of tests and equipment they provide. Therefore, it is important to contact the teacher in order to inform yourself of further symptoms (e.g. poor performance in reading/writing) and to schedule an appointment for a complete comprehensive optometric examination.

My child wears glasses, and his vision is now excellent, but he still complains that he can’t see well in school. Why would that be?

If the child recently got an eye exam and picked up his/her glasses a few days ago, it can simply be that the child needs to adjust to the new prescription. This adjustment period can vary for each person. The common length of this period is anywhere between 1-2 weeks. It is recommended, especially with children with higher prescriptions, to wear glasses full time in order to adjust specially to a first time wearer. However, if the child has not had a recent eye exam and it has been over a year, there is a high chance that the child needs the prescription updated. An annual eye exam is recommended for most people however; some children begin to notice changes as soon as 6 months. This slight change in prescription may be only obvious while at school since smaller print is more common compared to watching TV or being around the house. The third possibility can be that the child was not given the full prescription at his/her first eye exam. Optometrists commonly do this in order to avoid the patient from neglecting the glasses and feeling uncomfortable or dizzy with them on. These symptoms are common with patients with a higher prescription and the complete prescription is rarely given to first time wearers. The doctor will increase the prescription annually until the patient is able to accept the full prescription comfortably.

My child is not doing well in school, particularly in math, even though he is smart and works hard, and the teachers told me he should be evaluated by an eye doctor who specializes in children’s vision. Can you explain the connection between why he would having trouble in math and his vision?

Often times smart, hardworking children are judged by others as “lazy” and “dumb” especially when it comes to reading and mathematics due to the lack of interest and poor grades in the subject. It is sad that children are constantly being labeled as unintelligent even by teachers and worse by their own parents. This is due to parents, teachers, or guardians ignoring the signs that the child may have a learning related-vision problem. Math can be a very challenging subject if the child has a learning related vision problem. Mathematics is a very visual concept. For example, a child must be able to see the signs, symbols, and numbers clearly in order to succeed. A skill that is crucial in math is keeping the numbers lined up and organized, which can be especially difficult if the child has a visual problem. It is very common that if the child is doing poorly in math or reading it can be due to learning related vision problem. These visual problems interfere with the ability to perform to one’s full learning potential even if the child puts forth his/her best effort.

Are there different types of vision-related problems that can cause a child to have learning problems?

Some types of vision-related problems common in children include: -Nearsightedness -Farsightedness –Astigmatism -Amblyopia -Asthenopia -Convergence insufficiency -Strabismus -Diplopia -Perceptual vision problems -Accommodative insufficiency -Ocular motility dysfunction -Visual spatial orientation skill deficiency -Visual analysis skill deficiency -Visual motor skill deficiency -Auditory-visual integration deficiencies -Visual-verbal integration deficiencies

What are the symptoms of learning-related vision problems?

Some symptoms of learning-related vision problems may include, but is not limited to: -Excessive squinting, blinking, or rubbing of eyes -Headaches -Getting very close to a book or desk when reading and writing -Neglecting or avoiding near work specially reading -Lack of fluency reading -Poor handwriting -Short attention span for the child’s age or frequent daydreaming -Turning or tilting head to use one eye only or closing or covering one eye -Trouble finishing written, timed assignments -Difficulty remembering what is read -Omitting, repeating and miscalling words or confusing similar words -Persistent reversals after second grade -Difficulty with sequential concepts -Poor eye hand coordination when copying from chalkboard, throwing or catching a ball, buttoning or unbuttoning clothing or tying shoes -Displaying evidence of developmental immaturity -Inadequate ability to listen, think, speak, read, write, spell, or do mathematical calculations -Failure to use or properly understand phonological information when processing written or oral language -Difficulties with short-term or long-term memory that affect comprehension -Decreased word processing speed and efficiency, reduced reading rate, and compromised reading comprehension -Distractibility, inattentiveness -Distinct visual information processing deficits -Eye cross or turning in, out or moving independently of each other -Red, watery eyes, encrusted eyelids, frequent styes

 

What is the treatment for learning-related vision problems?

There are two common ways to treat a learning-related vision problem. The most common is to identify and correct refractive error. This can be resolved simply by using glasses. However, in some children, cases are more severe and will require vision therapy several times a week for a few months. Sessions vary in length and frequency depending on the severity. Doctors will custom design a treatment program in order to get the child back on the road to success. Occupational or physical therapy may be necessary when deficiencies are more severe.